{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:28:08Z","timestamp":1783056488494,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T00:00:00Z","timestamp":1396310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Azienda Ospedaliera OIRM-Sant'Anna"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the efficacy of transdermal clonidine in the treatment of severe refractory hyperemesis gravidarum (<jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content>), the most severe illness of pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The study had a randomised, double \u2010blind, placebo\u2010controlled, cross\u2010over design (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single tertiary referral hospital after admission of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Twelve women of gestational age 6\u201312\u00a0weeks and a major grade of <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> clinical severity who were unresponsive to standard antiemetic treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patients were randomly treated with and without the active drug (5\u00a0mg patch) for two consecutive periods of 5\u00a0days. The patients were allocated to a random list to receive first placebo and then active drug or the other way round. Other antiemetic drugs were administered on a scheduled or as\u2010needed basis. All patients received intravenous hydration and thiamine supplementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Pregnancy Unique Quantification of Emesis (<jats:styled-content style=\"fixed-case\">PUQE<\/jats:styled-content>) and visual analog scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) clinical scores, positive morning urine ketonuria, number of doses of standard antiemetic drugs required, and number of days off intravenous therapy were compared in the two periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Transdermal clonidine led to a significantly greater improvement compared with placebo of the primary (<jats:styled-content style=\"fixed-case\">PUQE<\/jats:styled-content> score <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00.026 <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.43\u20133.24; <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> score <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>=\u00a00.010 <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.17\u201312.83) and secondary outcome measures. A reduction of blood pressure was reported for systolic 6\u00a0mmHg <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00.01 and diastolic 3\u00a0mmHg <jats:italic>P<\/jats:italic>\u00a0=\u00a00.055.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This preliminary <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content> demonstrates the efficacy of transdermal clonidine in the treatment of severe <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content>, leading to a significant reduction of symptoms and reducing the need for other supportive measures and medications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12757","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T06:21:09Z","timestamp":1396333269000},"page":"1556-1562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Transdermal clonidine in the treatment of severe hyperemesis. 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